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General NPI Number Information
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NPI Number | 1114164480
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Entity Type | Individual
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Provider Name | HAMID REZA KASHANI MADJD D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 01/08/2009
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Last Update Date | 12/28/2016
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Provider Practice Location Address
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Address Line | 3701 W NORTHWEST HIGHWAY SUITE # 306
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City | DALLAS
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State | TX
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Zip | 75220
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Country | US
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Telephone | 214-353-0683
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Fax | 972-764-8760
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Provider Business Mailing Address
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Address Line | 3701 W NORTHWEST HIGHWAY SUITE # 306
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City | DALLAS
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State | TX
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Zip | 75220
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Country | US
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Telephone | 214-353-0683
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Fax | 972-764-8760
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 24349
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0024349
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License Number State | TX
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